日本外傷データバンクを用いたスポーツ関連外傷の疫学データの推移と予後関連因子に関する研究

【背景】スポーツ関連外傷は,重大な疫学的問題である.本研究の目的は,本邦において,スポーツ関連外傷において小児と成人の違いなど疫学的特徴を評価し,予後関連因子を探索することである.【方法】日本外傷データバンク (JTDB) を用いて後方視的な解析を行った.2004年から2018年に入院したスポーツ関連外傷を対象とした.ロジスティック回帰分析を行い,院内死亡と関連する因子を探索した.【結果】対象患者5,828例を同定し,2,429例が小児,3,399例が成人であった.年齢の中央値は21歳で,83.8%が男性であった.小児で最も多い季節は4-6月 (30.6%) であり,成人で最も多い季節は1-3...

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Published inデサントスポーツ科学 Vol. 44; pp. 137 - 146
Main Authors 中川, 雄公, 廣瀬, 智也, 片山, 祐介, 北村, 哲久, 中尾, 俊一郎
Format Journal Article
LanguageJapanese
Published 公益財団法人 石本記念デサントスポーツ科学振興財団 22.02.2023
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ISSN0285-5739
2758-4429
DOI10.57488/descente.44.0_137

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Abstract 【背景】スポーツ関連外傷は,重大な疫学的問題である.本研究の目的は,本邦において,スポーツ関連外傷において小児と成人の違いなど疫学的特徴を評価し,予後関連因子を探索することである.【方法】日本外傷データバンク (JTDB) を用いて後方視的な解析を行った.2004年から2018年に入院したスポーツ関連外傷を対象とした.ロジスティック回帰分析を行い,院内死亡と関連する因子を探索した.【結果】対象患者5,828例を同定し,2,429例が小児,3,399例が成人であった.年齢の中央値は21歳で,83.8%が男性であった.小児で最も多い季節は4-6月 (30.6%) であり,成人で最も多い季節は1-3月 (37.5%) であった.院内死亡は1.2%で,多変量解析の結果,男性,頭頸部外傷,胸部外傷は院内死亡と有意に関連していた (aOR 4.11[95% CI 1.49-17.02],P=0.018; aOR 18.00[95% CI 10.06-33.92],P<0.001; aOR 4.18[95% CI 2.27-7.50],P<0.001).【結語】JTDBを用いてスポーツ外傷の疫学を分析した.男性,頭頸部外傷,胸部外傷は院内死亡と有意に関連していた.
AbstractList 【背景】スポーツ関連外傷は,重大な疫学的問題である.本研究の目的は,本邦において,スポーツ関連外傷において小児と成人の違いなど疫学的特徴を評価し,予後関連因子を探索することである.【方法】日本外傷データバンク (JTDB) を用いて後方視的な解析を行った.2004年から2018年に入院したスポーツ関連外傷を対象とした.ロジスティック回帰分析を行い,院内死亡と関連する因子を探索した.【結果】対象患者5,828例を同定し,2,429例が小児,3,399例が成人であった.年齢の中央値は21歳で,83.8%が男性であった.小児で最も多い季節は4-6月 (30.6%) であり,成人で最も多い季節は1-3月 (37.5%) であった.院内死亡は1.2%で,多変量解析の結果,男性,頭頸部外傷,胸部外傷は院内死亡と有意に関連していた (aOR 4.11[95% CI 1.49-17.02],P=0.018; aOR 18.00[95% CI 10.06-33.92],P<0.001; aOR 4.18[95% CI 2.27-7.50],P<0.001).【結語】JTDBを用いてスポーツ外傷の疫学を分析した.男性,頭頸部外傷,胸部外傷は院内死亡と有意に関連していた.
Author 中尾, 俊一郎
中川, 雄公
片山, 祐介
北村, 哲久
廣瀬, 智也
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References 7) Dwek, J.R. A Structural and Mechanism-Based Perspective toward Understanding Pediatric and Adult Sports Injuries. Am. J. Roentgenol., 206, 980–986, doi:10.2214/AJR.15.15937(2016)
5) Caine, D.; Maffulli, N.; Caine, C. Epidemiology of Injury in Child and Adolescent Sports: Injury Rates, Risk Factors, and Prevention. Clin. Sports Med., 27, 19–50, doi:10.1016/j.csm.2007.10.008(2008)
24) Nakao, S.; Katayama, Y.; Hirayama, A.; Hirose, T.; Ishida, K.; Umemura, Y.; Tachino, J.; Kiguchi, T.; Matsuyama, T.; Kiyohara, K.; et al. Characteristics and Outcomes of Pediatric Blunt Renal Trauma: A Nationwide Cohort Study in Japan. Eur. J. Trauma Emerg. Surg., doi:10.1007/s00068-021-01795-w(2021)
4) Caine, D.; Caine, C.; Maffulli, N. Incidence and Distribution of Pediatric Sport-Related Injuries. Clin. J. Sport Med., 16, 500–513, doi:10.1097/01.jsm.0000251181.36582.a0(2006)
20) Akiyama, T. Undokai and Sports Events in the Japanese School System. Pediatr. Int., 62, 1230–1233, doi:10.1111/ped.14332(2020)
17) Weber, C.D.; Horst, K.; Lefering, R.; Hofman, M.; Dienstknecht, T.; Pape, H.C. Major Trauma in Winter Sports: An International Trauma Database Analysis. Eur. J. Trauma Emerg. Surg., 42, 741–747, doi:10.1007/s00068-015-0596-7(2016)
8) Scarneo, S.E.; Kerr, Z.Y.; Kroshus, E.; Register-Mihalik, J.K.; Hosokawa, Y.; Stearns, R.L.; DiStefano, L.J.; Casa, D.J. The Socioecological Framework: A Multifaceted Approach to Preventing Sport-Related Deaths in High School Sports. J. Athl. Train., 54, 356–360, doi:10.4085/1062-6050-173-18(2019)
6) Mcguine, T. Sports Injuries in High School Athletes : A Review of Injury-Risk and Injury-Prevention Research. Clin. J. Sport Med., 16, 488–499(2006)
15) Winkler, E.A.; Yue, J.K.; Burke, J.F.; Chan, A.K.; Dhall, S.S.; Berger, M.S.; Manley, G.T.; Tarapore, P.E. Adult Sports-Related Traumatic Brain Injury in United States Trauma Centers. Neurosurg. Focus, 40, 1–12, doi:10.3171/2016.1.FOCUS15613(2016)
13) Centers for Disease Control and Prevention Child Development Available online: https://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/index.html (accessed on 30 May 2022)
10) Japan Trauma Care and Research Japan Trauma Data Bank Report 2019 Available online: https://www.jtcr-jatec.org/traumabank/dataroom/data/JTDB2019e.pdf (accessed on 30 April 2021)
18) Eun, J.C.; Bronsert, M.; Hansen, K.; Moulton, S.L.; Jazaeri, O.; Nehler, M.R.; Greenberg, J.I. Vascular Injury Is Associated with Increased Mortality in Winter Sports Trauma. Ann. Vasc. Surg., 29, 109–113, doi:10.1016/j.avsg.2014.10.003(2015)
1) Mock, C.; Joshipura, M.; Arreola-Risa, C.; Quansah, R. An Estimate of the Number of Lives That Could Be Saved through Improvements in Trauma Care Globally. World J. Surg., 36, 959–963, doi:10.1007/s00268-012-1459-6(2012)
2) Petridou, E.; Kedikoglou, S.; Belechri, M.; Papadopoulos, F.; Alexe, D.M.; Trichopoulos, D.; Robert, B.; Leben, S.; Rosa, G.; Thomas, H.; et al. Sports Injuries among Adults in Six European Union Countries. Eur. J. Trauma, 29, 278–283, doi:10.1007/s00068-003-1295-3(2003)
3) Green, R.S.; Butler, M.B.; Kureshi, N.; Erdogan, M. A Retrospective Evaluation of Pediatric Major Trauma Related to Sport and Recreational Activities in Nova Scotia. Can. J. Emerg. Med., 18, 106–111, doi:10.1017/cem.2015.69(2016)
12) Neidel, T.; Salvador, N.; Heller, R. Impact of Systolic Blood Pressure Limits on the Diagnostic Value of Triage Algorithms. Scand. J. Trauma Resusc. Emerg. Med., 25(2017)
19) De Roulet, A.; Inaba, K.; Strumwasser, A.; Chouliaras, K.; Lam, L.; Benjamin, E.; Grabo, D.; Demetriades, D. Severe Injuries Associated with Skiing and Snowboarding: A National Trauma Data Bank Study. J. Trauma Acute Care Surg., 82, 781–786, doi:10.1097/TA.0000000000001358(2017)
26) Cantu, R.C.; Mueller, F.O. The Prevention of Catastrophic Head and Spine Injuries in High School and College Sports. Br. J. Sports Med., 43, 981–986, doi:10.1136/bjsm.2009.067728(2009)
14) Yue, J.K.; Winkler, E.A.; Burke, J.F.; Chan, A.K.; Dhall, S.S.; Berger, M.S.; Manley, G.T.; Tarapore, P.E. Pediatric Sports-Related Traumatic Brain Injury in United States Trauma Centers. Neurosurg. Focus, 40, 1–12, doi:10.3171/2016.1.FOCUS15612(2016)
22) LEVY, J.L.; LINDER, L.H. Major Abdominal Trauma in Children. Am. J. Surg., 120, 55–58(1970)
27) Classie JA, Distel LM, Borchers JR. Safety baseballs and chest protectors: a systematic review on the prevention of commotio cordis. Phys. Sportsmed., Apr;38 (1) :83-90. doi: 10.3810/psm.2010.04.1765(2010)
9) Kobayashi, K. Challenges for Improving Trauma Care in Japan. J. Trauma - Inj. Infect. Crit. Care, 58, 1134–1139, doi:10.1097/01.TA.0000169953.29347.81(2005)
11) BAKER, S.P.; O’NEILL, B.; HADDON, W.J.; LONG, W.B. The Injury Severity Score: A Method for Describing Patients with Multiple Injuries and Evaluating Emergency Care. J. Trauma Inj. Infect. Crit. Care, 14, 187–196(1974)
16) Tachino J, Katayama Y, Kitamura T, Kiyohara K, Nakao S, Umemura Y, Ishida K, Hirose T, Nakagawa Y, Shimazu T. Assessment of the interaction effect between injury regions in multiple injuries: A nationwide cohort study in Japan. J. Trauma Acute Care Surg. Jan 1;90 (1) :185-190. doi: 10.1097/TA.0000000000002969(2021)
23) Patel, D.P.; Redshaw, J.D.; Breyer, B.N.; Smith, T.G.; Erickson, A.; Majercik, S.D.; Gaither, T.W.; Craig, J.R.; Gardner, S.; Presson, A.P.; et al. High-Grade Renal Injuries Are Often Isolated in Sports-Related Trauma Darshan. Injury, 46, 1245–1249, doi:10.1016/j.Injury.2015.02.008.High-grade(2016)
21) Kissoon, N.; Dreyer, J.; Walia, M. Pediatric Trauma: Differences in Pathophysiology, Injury Patterns and Treatment Compared with Adult Trauma. Cmaj, 142, 27–34(1990)
25) Cross, K.M.; Serenelli, C. Training and Equipment to Prevent Athletic Head and Neck Injuries. Clin. Sports Med., 22, 639–667, doi:10.1016/S0278-5919 (02) 00099-6(2003)
References_xml – reference: 2) Petridou, E.; Kedikoglou, S.; Belechri, M.; Papadopoulos, F.; Alexe, D.M.; Trichopoulos, D.; Robert, B.; Leben, S.; Rosa, G.; Thomas, H.; et al. Sports Injuries among Adults in Six European Union Countries. Eur. J. Trauma, 29, 278–283, doi:10.1007/s00068-003-1295-3(2003)
– reference: 6) Mcguine, T. Sports Injuries in High School Athletes : A Review of Injury-Risk and Injury-Prevention Research. Clin. J. Sport Med., 16, 488–499(2006)
– reference: 26) Cantu, R.C.; Mueller, F.O. The Prevention of Catastrophic Head and Spine Injuries in High School and College Sports. Br. J. Sports Med., 43, 981–986, doi:10.1136/bjsm.2009.067728(2009)
– reference: 1) Mock, C.; Joshipura, M.; Arreola-Risa, C.; Quansah, R. An Estimate of the Number of Lives That Could Be Saved through Improvements in Trauma Care Globally. World J. Surg., 36, 959–963, doi:10.1007/s00268-012-1459-6(2012)
– reference: 27) Classie JA, Distel LM, Borchers JR. Safety baseballs and chest protectors: a systematic review on the prevention of commotio cordis. Phys. Sportsmed., Apr;38 (1) :83-90. doi: 10.3810/psm.2010.04.1765(2010)
– reference: 16) Tachino J, Katayama Y, Kitamura T, Kiyohara K, Nakao S, Umemura Y, Ishida K, Hirose T, Nakagawa Y, Shimazu T. Assessment of the interaction effect between injury regions in multiple injuries: A nationwide cohort study in Japan. J. Trauma Acute Care Surg. Jan 1;90 (1) :185-190. doi: 10.1097/TA.0000000000002969(2021)
– reference: 12) Neidel, T.; Salvador, N.; Heller, R. Impact of Systolic Blood Pressure Limits on the Diagnostic Value of Triage Algorithms. Scand. J. Trauma Resusc. Emerg. Med., 25(2017)
– reference: 24) Nakao, S.; Katayama, Y.; Hirayama, A.; Hirose, T.; Ishida, K.; Umemura, Y.; Tachino, J.; Kiguchi, T.; Matsuyama, T.; Kiyohara, K.; et al. Characteristics and Outcomes of Pediatric Blunt Renal Trauma: A Nationwide Cohort Study in Japan. Eur. J. Trauma Emerg. Surg., doi:10.1007/s00068-021-01795-w(2021)
– reference: 4) Caine, D.; Caine, C.; Maffulli, N. Incidence and Distribution of Pediatric Sport-Related Injuries. Clin. J. Sport Med., 16, 500–513, doi:10.1097/01.jsm.0000251181.36582.a0(2006)
– reference: 5) Caine, D.; Maffulli, N.; Caine, C. Epidemiology of Injury in Child and Adolescent Sports: Injury Rates, Risk Factors, and Prevention. Clin. Sports Med., 27, 19–50, doi:10.1016/j.csm.2007.10.008(2008)
– reference: 23) Patel, D.P.; Redshaw, J.D.; Breyer, B.N.; Smith, T.G.; Erickson, A.; Majercik, S.D.; Gaither, T.W.; Craig, J.R.; Gardner, S.; Presson, A.P.; et al. High-Grade Renal Injuries Are Often Isolated in Sports-Related Trauma Darshan. Injury, 46, 1245–1249, doi:10.1016/j.Injury.2015.02.008.High-grade(2016)
– reference: 18) Eun, J.C.; Bronsert, M.; Hansen, K.; Moulton, S.L.; Jazaeri, O.; Nehler, M.R.; Greenberg, J.I. Vascular Injury Is Associated with Increased Mortality in Winter Sports Trauma. Ann. Vasc. Surg., 29, 109–113, doi:10.1016/j.avsg.2014.10.003(2015)
– reference: 20) Akiyama, T. Undokai and Sports Events in the Japanese School System. Pediatr. Int., 62, 1230–1233, doi:10.1111/ped.14332(2020)
– reference: 3) Green, R.S.; Butler, M.B.; Kureshi, N.; Erdogan, M. A Retrospective Evaluation of Pediatric Major Trauma Related to Sport and Recreational Activities in Nova Scotia. Can. J. Emerg. Med., 18, 106–111, doi:10.1017/cem.2015.69(2016)
– reference: 15) Winkler, E.A.; Yue, J.K.; Burke, J.F.; Chan, A.K.; Dhall, S.S.; Berger, M.S.; Manley, G.T.; Tarapore, P.E. Adult Sports-Related Traumatic Brain Injury in United States Trauma Centers. Neurosurg. Focus, 40, 1–12, doi:10.3171/2016.1.FOCUS15613(2016)
– reference: 17) Weber, C.D.; Horst, K.; Lefering, R.; Hofman, M.; Dienstknecht, T.; Pape, H.C. Major Trauma in Winter Sports: An International Trauma Database Analysis. Eur. J. Trauma Emerg. Surg., 42, 741–747, doi:10.1007/s00068-015-0596-7(2016)
– reference: 19) De Roulet, A.; Inaba, K.; Strumwasser, A.; Chouliaras, K.; Lam, L.; Benjamin, E.; Grabo, D.; Demetriades, D. Severe Injuries Associated with Skiing and Snowboarding: A National Trauma Data Bank Study. J. Trauma Acute Care Surg., 82, 781–786, doi:10.1097/TA.0000000000001358(2017)
– reference: 7) Dwek, J.R. A Structural and Mechanism-Based Perspective toward Understanding Pediatric and Adult Sports Injuries. Am. J. Roentgenol., 206, 980–986, doi:10.2214/AJR.15.15937(2016)
– reference: 13) Centers for Disease Control and Prevention Child Development Available online: https://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/index.html (accessed on 30 May 2022)
– reference: 21) Kissoon, N.; Dreyer, J.; Walia, M. Pediatric Trauma: Differences in Pathophysiology, Injury Patterns and Treatment Compared with Adult Trauma. Cmaj, 142, 27–34(1990)
– reference: 10) Japan Trauma Care and Research Japan Trauma Data Bank Report 2019 Available online: https://www.jtcr-jatec.org/traumabank/dataroom/data/JTDB2019e.pdf (accessed on 30 April 2021)
– reference: 25) Cross, K.M.; Serenelli, C. Training and Equipment to Prevent Athletic Head and Neck Injuries. Clin. Sports Med., 22, 639–667, doi:10.1016/S0278-5919 (02) 00099-6(2003)
– reference: 9) Kobayashi, K. Challenges for Improving Trauma Care in Japan. J. Trauma - Inj. Infect. Crit. Care, 58, 1134–1139, doi:10.1097/01.TA.0000169953.29347.81(2005)
– reference: 8) Scarneo, S.E.; Kerr, Z.Y.; Kroshus, E.; Register-Mihalik, J.K.; Hosokawa, Y.; Stearns, R.L.; DiStefano, L.J.; Casa, D.J. The Socioecological Framework: A Multifaceted Approach to Preventing Sport-Related Deaths in High School Sports. J. Athl. Train., 54, 356–360, doi:10.4085/1062-6050-173-18(2019)
– reference: 11) BAKER, S.P.; O’NEILL, B.; HADDON, W.J.; LONG, W.B. The Injury Severity Score: A Method for Describing Patients with Multiple Injuries and Evaluating Emergency Care. J. Trauma Inj. Infect. Crit. Care, 14, 187–196(1974)
– reference: 22) LEVY, J.L.; LINDER, L.H. Major Abdominal Trauma in Children. Am. J. Surg., 120, 55–58(1970)
– reference: 14) Yue, J.K.; Winkler, E.A.; Burke, J.F.; Chan, A.K.; Dhall, S.S.; Berger, M.S.; Manley, G.T.; Tarapore, P.E. Pediatric Sports-Related Traumatic Brain Injury in United States Trauma Centers. Neurosurg. Focus, 40, 1–12, doi:10.3171/2016.1.FOCUS15612(2016)
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Snippet 【背景】スポーツ関連外傷は,重大な疫学的問題である.本研究の目的は,本邦において,スポーツ関連外傷において小児と成人の違いなど疫学的特徴を評価し,予後関連因子を...
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SubjectTerms スポーツ関連外傷
日本外傷データバンク
死亡率
疫学
Title 日本外傷データバンクを用いたスポーツ関連外傷の疫学データの推移と予後関連因子に関する研究
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